Alhambra, CA
4 of 5
CMS star rating
144
Beds
4,262
Inpatient discharges a year
$91.8M
Net patient revenue a year
15
In-network payers
Alhambra Hospital is a 144-bed proprietary hospital in Alhambra, CA. Below you'll find publicly disclosed negotiated rates and facility details, including 15 in-network payers and 120 disclosed rate categories.
The 24 services Alhambra Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
Gynecology
CPT 58558
$974 - $10,120
from 3 insurers · median $3,993
11 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
Medicine & Surgery
CPT 66984
$1,124 - $10,120
from 3 insurers · median $6,425
73 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
CT imaging
CPT 74177
$323 - $2,994
from 4 insurers · median $876
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$172 - $1,620
from 4 insurers · median $736
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$117 - $1,112
from 2 insurers · median $614
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$695 - $3,187
from 4 insurers · median $1,772
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$929 - $4,615
from 3 insurers · median $1,586
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$6,950 - $17,597
from 2 insurers · median $12,274
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$929 - $4,615
from 3 insurers · median $2,026
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$929 - $4,615
from 3 insurers · median $1,641
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$156 - $1,320
from 4 insurers · median $767
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 743
$3,817 - $13,874
from 4 insurers · median $5,557
Hospital reports inpatient surgical services to CMS
Digestive procedures
CPT 49650
$5,634 - $17,597
from 2 insurers · median $11,616
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93971
$241 - $1,423
from 4 insurers · median $1,195
Common here, based on CMS Medicare volume
CT imaging
CPT 71260
$226 - $2,690
from 4 insurers · median $847
Common here, based on CMS Medicare volume
Gynecology
CPT 58661
$5,473 - $17,597
from 2 insurers · median $11,535
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93970
$547 - $1,789
from 3 insurers · median $1,334
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$28 - $199
from 4 insurers · median $159
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$444 - $3,050
from 4 insurers · median $2,162
Common here, based on CMS Medicare volume
MRI imaging
CPT 70551
$359 - $4,145
from 4 insurers · median $978
Common here, based on CMS Medicare volume
Gynecology
CPT 58662
$4,988 - $17,597
from 2 insurers · median $11,292
Typical for a hospital with this service line
Medicine & Surgery
CPT 42820
$3,782 - $10,120
from 2 insurers · median $6,951
Typical for a hospital with this service line
Gynecology
CPT 58571
$4,656 - $17,597
from 3 insurers · median $5,187
Typical for a hospital with this service line
MRI imaging
CPT 70553
$245 - $1,562
from 3 insurers · median $792
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 12 | 438% | 6 | 6 |
| Insurer B* | 23 | 273% | 14 | 4 |
| Insurer C* | 23 | 168% | 13 | 7 |
| Insurer D* | 18 | 76% | 8 | 4 |
How we chose these services: 2 appear in this hospital's own Medicare claims, 15 are common here based on CMS Medicare volume, and 7 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Alhambra Hospital, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
4 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$91.8M net patient revenue
Ownership and leadership
Owned by Alhambra Hospital Medical Center, LP
The employer identification numbers (EINs) health plans and networks list for Alhambra Hospital in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 95-4693289Alhambra Hospital Medical Center L.P. | 19Aetna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Aspirus Health Plan, Asuris Northwest Health and 14 more | 1811099674 Alhambra Hospital Medical Center LP1679602668 Alhambra Hospital Medical Center LP1770612756 Alhambra Hospital Medical Center LPand 8 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
100 South Raymond Avenue, Alhambra, CA 91801
How Alhambra Hospital compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
4 of 5
Higher than 58% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
Better on 1 of 4 measures
1 better, 3 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
Better on 1 of 4 measures
1 better, 3 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Worse on 1 of 3 measures
0 better, 2 no different, 1 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
3 of 5
Lower than 40% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
69%
Lower than 57% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Not penalized
Not among the worst-performing 25%
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
0.96
Lower than 53% of US hospitals
US median: 0.96
Risk-adjusted composite of complications such as bedsores, falls with hip fracture and blood clots after surgery; lower is better
Time in the ER before going home
133 min
Lower than 62% of US hospitals
US median: 148 min
Median minutes from arrival to leaving for ER patients who were sent home; lower is better
Sepsis care
62%
Lower than 57% of US hospitals
US median: 65%
Patients with severe sepsis or septic shock who got every step of the recommended early treatment; higher is better
| Measure | Result | Period |
|---|---|---|
| Overall star ratingCMS: Overall hospital quality star rating | 4 of 5 | |
| Death rates | Better on 1 of 4 measures | |
| Safety | Better on 1 of 4 measures | |
| Readmissions | Worse on 1 of 3 measures | |
| Patient survey ratingCMS: Summary star rating | 3 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 69% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Not penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 0.96 | 2022-07-01 to 2024-06-30 |
| Time in the ER before going homeCMS: Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better | 133 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 62% | 2024-10-01 to 2025-09-30 |
Source: CMS Provider Data Catalog, released 2026-08-13. US comparisons rank this facility among every facility CMS reports for each measure. See Medicare Care Compare.
How Medicare adjusts Alhambra Hospital's inpatient payments for its readmissions, quality and cost results.
-0.29% on Medicare payments
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
+0.52% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2027 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2027).
Each result CMS publishes for Alhambra Hospital, beside the US median and the average of CA hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 4.075 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 991 cases | 4.2 | 3.9 | 3.81 | Worse than 63% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 · 38 cases | 11.4 | 11.8 | 11.57 | Better than 63% of US hospitals | |
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.379 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 · 25 cases | 9.2 | 8.5 | 8.235 | Worse than 68% of US hospitals | |
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 62 cases | 10.7 | 11 | 10.29 | Better than 55% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 262 cases | 12.1 | 15.2 | 14.49 | Better than 90% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 · 47 cases | 12.8 | 11.6 | 11.57 | Worse than 68% of US hospitals | |
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 1,653 cases | 0.34 | 0.51 | 0.4818 | No Different Than the National Rate | Better than 75% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 171 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 1,764 cases | 0.2 | 0.2 | 0.21 | No Different Than the National Rate | Better than 46% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 1,866 cases | 0.25 | 0.27 | 0.261 | No Different Than the National Rate | Better than 71% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 150 cases | 2.26 | 2.29 | 2.308 | No Different Than the National Rate | Better than 55% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 · 39 cases | 1.67 | 1.63 | 1.668 | No Different Than the National Rate | Worse than 72% of US hospitals |
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 · 42 cases | 11.52 | 8.88 | 9.555 | No Different Than the National Rate | Worse than 80% of US hospitals |
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 154 cases | 3.24 | 3.4 | 3.521 | No Different Than the National Rate | Better than 65% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 · 40 cases | 5.08 | 5.105 | 5.495 | No Different Than the National Rate | Better than 52% of US hospitals |
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 · 68 cases | 1.74 | 1.72 | 1.796 | No Different Than the National Rate | Worse than 59% of US hospitals |
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 390 cases | 1.28 | 1.02 | 1.061 | No Different Than the National Rate | Worse than 87% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.09 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 71 cases | 5.7 | 1.25 | 7.901 | Worse than 56% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 285 cases | 32.5 | 3.85 | 16.67 | Worse than 84% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 | Not Available | 12.91 | Number of Cases Too Small | ||
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 11.39 | |||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.546 | |||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 | Not Available | 1.001 | Number of cases too small | ||
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 40 cases | 14.2 | 14.4 | 14.43 | Better than 55% of US hospitals | |
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 11.19 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 69 cases | 20.3 | 19.8 | 19.94 | Worse than 69% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 146 cases | 23.1 | 21.3 | 21.41 | Worse than 91% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 5.612 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 362 cases | 17.8 | 17.2 | 17.7 | Worse than 70% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2347 | No Different than National Benchmark | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | 2.587 | 1.504 | 1.834 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 1,597 | 1,370 | 5,722 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 1.158 | 0.9835 | 5.638 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 3.347 | No Different than National Benchmark | |
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | 0 | 0.484 | 0.5696 | No Different than National Benchmark | The best result, shared by 21% of US hospitals |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2147 | No Different than National Benchmark | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | 2.414 | 1.392 | 1.749 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 1,764 | 1,799 | 5,308 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 1.241 | 1.377 | 6.105 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 3.273 | No Different than National Benchmark | |
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | 0 | 0.399 | 0.5366 | No Different than National Benchmark | The best result, shared by 24% of US hospitals |
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.32 | No Different than National Benchmark | ||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | 2.438 | 2.135 | 2.433 | No Different than National Benchmark | |
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 51 | 61 | 112 | No Different than National Benchmark | |
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 1.229 | 1.591 | 2.999 | No Different than National Benchmark | |
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 0 | 1 | 2.368 | No Different than National Benchmark | |
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | 0 | 0.7155 | 0.8107 | No Different than National Benchmark | The best result, shared by 19% of US hospitals |
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2606 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.273 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | 4 | 38 | 73.49 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.032 | 0.328 | 0.6136 | ||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 0.5911 | ||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 0.7863 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3103 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.305 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 20,017 | 14,451 | 52,601 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.783 | 0.567 | 3.111 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 2.166 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.7784 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.006 | 0.127 | 0.1925 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 0.575 | 0.747 | 0.9502 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 20,017 | 13,646 | 48,317 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 8.574 | 5.683 | 27.04 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 1 | 2 | 9.99 | Better than the National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 0.117 | 0.279 | 0.383 | Better than the National Benchmark | Better than 73% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 496 cases | 77 | 73 | 72.2 | Better than 64% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 496 cases | 6 | 8 | 8.78 | Better than 65% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 496 cases | 17 | 18 | 19.02 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 496 cases | 90 | 87 | 86.82 | Better than 74% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 496 cases | 4 | 4 | 3.514 | Better than 47% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 496 cases | 75 | 80 | 75.76 | Worse than 78% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 496 cases | 90 | 91 | 89.84 | Worse than 66% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 496 cases | 6 | 4 | 5.713 | Worse than 76% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 496 cases | 3 | 3 | 2.855 | Worse than 49% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 496 cases | 19 | 16 | 18.53 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 496 cases | 74 | 79 | 75.81 | Worse than 83% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 496 cases | 88 | 91 | 89.11 | Worse than 83% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 496 cases | 7 | 5 | 7.043 | Worse than 72% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 496 cases | 2 | 3 | 2.688 | Worse than 71% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 496 cases | 19 | 16 | 17.15 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 496 cases | 63 | 61 | 58.95 | Better than 58% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 496 cases | 78 | 77 | 75.75 | Better than 57% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 496 cases | 21 | 19 | 21.56 | Worse than 58% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 496 cases | 3 | 3 | 2.449 | Better than 47% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 496 cases | 16 | 19 | 19.48 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 496 cases | 84 | 86 | 84.61 | Worse than 66% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 496 cases | 15 | 13 | 15.03 | Worse than 63% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 496 cases | 3 | 3 | 3.08 | Worse than 45% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 496 cases | 85 | 87 | 84.97 | Worse than 63% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 496 cases | 17 | 14 | 16.39 | Worse than 68% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 496 cases | 83 | 86 | 83.61 | Worse than 68% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 496 cases | 70 | 74 | 70.69 | Worse than 74% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 496 cases | 9 | 7 | 8.855 | Worse than 75% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 496 cases | 21 | 19 | 20.45 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 496 cases | 72 | 77 | 73.94 | Worse than 82% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 496 cases | 7 | 6 | 7.637 | Worse than 64% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 496 cases | 21 | 17 | 18.43 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 496 cases | 80 | 85 | 81.99 | Worse than 85% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 496 cases | 5 | 3 | 4.958 | Worse than 73% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 496 cases | 15 | 11 | 13.06 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 496 cases | 8 | 8 | 10.01 | Worse than 48% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 496 cases | 22 | 20 | 22.36 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 496 cases | 70 | 72 | 67.63 | Worse than 55% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 496 cases | 88 | 88 | 86.85 | Worse than 45% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 496 cases | 3 | 3 | 3.047 | Worse than 45% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 496 cases | 72 | 74 | 72.06 | Worse than 62% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 496 cases | 13 | 9 | 10.94 | Worse than 80% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 496 cases | 15 | 16 | 17 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 496 cases | 72 | 75 | 71.11 | Worse than 67% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 496 cases | 8 | 5 | 7.488 | Worse than 78% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 496 cases | 20 | 20 | 21.4 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 496 cases | 73 | 77 | 72.49 | Worse than 70% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 496 cases | 5 | 4 | 6.121 | Worse than 55% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 496 cases | 22 | 19 | 21.39 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 496 cases | 81 | 86 | 82.8 | Worse than 83% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 496 cases | 4 | 3 | 3.779 | Worse than 72% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 496 cases | 15 | 11 | 13.42 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 496 cases | 51 | 59 | 47.5 | Worse than 77% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 496 cases | 15 | 9 | 17.79 | Worse than 79% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 496 cases | 34 | 31 | 34.71 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 496 cases | 77 | 82 | 74.85 | Worse than 76% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 496 cases | 2 | 3 | 2.203 | Worse than 76% of US hospitals | |
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 · 496 cases | 7 | 5 | 7.623 | Worse than 67% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 496 cases | 69 | 71 | 68.6 | Worse than 57% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 496 cases | 86 | 87 | 85.85 | Worse than 58% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 496 cases | 24 | 23 | 23.77 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 496 cases | 3 | 4 | 3.431 | Worse than 58% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 496 cases | 54 | 47 | 45.33 | Better than 78% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 496 cases | 29 | 30 | 32.51 | Better than 55% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 496 cases | 17 | 22 | 22.16 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 496 cases | 3 | 3 | 2.859 | Worse than 40% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 496 cases | 14 | 12 | 13.94 | Worse than 63% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 496 cases | 86 | 88 | 86.06 | Worse than 63% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | medium | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 | Not Available | 8.289 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 1.008 | |||
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.1852 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 979 cases | 65 | 79 | 69.96 | Worse than 71% of US hospitals | |
| Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 543 cases | 134 | 154 | 187 | Better than 67% of US hospitals | |
| Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better2024-10-01 to 2025-09-30 · 521 cases | 133 | 148 | 182 | Better than 62% of US hospitals | |
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 · 17 cases | 215 | 247 | 282 | Better than 63% of US hospitals | |
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 411 | |||
| Left before being seen2024-01-01 to 2024-12-31 · 20,389 cases | 1 | 1 | 2.162 | Better than 42% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 75.06 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 89 cases | 100 | 97 | 92.55 | The best result, shared by 27% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 80 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 48.75 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 614 cases | 15 | 15 | 13.67 | Worse than 48% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 267 cases | 62 | 65 | 68.8 | Worse than 57% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 106 cases | 61 | 73 | 76.38 | Worse than 75% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 51 cases | 86 | 88 | 86.64 | Worse than 57% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 267 cases | 87 | 82 | 82.89 | Better than 69% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 176 cases | 94 | 94 | 93.98 | Worse than 49% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 93.4 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 70.68 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 · 56 cases | 89 | 94 | 89.93 | Worse than 83% of US hospitals | |
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 2,799 cases | 94 | 90 | 86.9 | Better than 65% of US hospitals | |
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 465 cases | 98 | 97 | 94.78 | Better than 56% of US hospitals |
How often scans were ordered when they may not be needed; lower is better.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 0 | 5 | 4.959 | The best result, shared by 2% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | Not Available | 8.417 |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 1.18 | 0.99 | 1.024 | Worse than 97% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 35 | 20 | 30.07 | Better than 76% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 8.75 | 5 | 7.571 | Better than 75% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 0 | 10 | 16.48 | The worst result, shared by 43% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 0 | 2.5 | 4.567 | The worst result, shared by 43% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 41 | 34 | 28.67 | Better than 62% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 10.25 | 8.75 | 7.519 | Better than 62% of US hospitals | |
| VBP safety domain scoreFY 2026 | 70 | 40 | 45.16 | Better than 89% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 17.5 | 10 | 11.79 | Better than 88% of US hospitals | |
| VBP total performance scoreFY 2026 | 36.5 | 29.5 | 30.43 | Better than 72% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 75 | 85 | 50 | 20 | 10 | 35 |
| VBP clinical outcomes weighted domain score | 18.75 | 21.25 | 12.5 | 5 | 2.5 | 8.75 |
| VBP efficiency and cost reduction domain score | 0 | Not Available | 10 | 10 | 0 | 0 |
| VBP efficiency and cost reduction weighted domain score | 0 | Not Available | 2.5 | 2.5 | 0 | 0 |
| VBP person and community engagement domain score | 64 | Not Available | Not Available | 19 | 17 | 41 |
| VBP person and community engagement weighted domain score | 16 | Not Available | Not Available | 4.75 | 4.25 | 10.25 |
| VBP safety domain score | 83.33 | Not Available | Not Available | 25 | 27.5 | 70 |
| VBP safety weighted domain score | 20.83 | Not Available | Not Available | 6.25 | 6.875 | 17.5 |
| VBP total performance score | 55.58 | Not Available | Not Available | 18.5 | 13.63 | 36.5 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.015 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 1.005 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | N/A | 1.002 | |||
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 · 56 cases | 1.02 | 0.9983 | 1.017 | Worse than 64% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9788 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 · 235 cases | 1.042 | 0.9955 | 1.026 | Worse than 76% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | 0.9805 | N/A | N/A | N/A | N/A | N/A |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 0.9556 | 0.9545 | 1.006 | N/A | N/A | N/A |
| READM-30-HF-HRRP | 1.045 | 1.028 | 0.9784 | 1.004 | 0.9865 | 1.02 |
| READM-30-HIP-KNEE-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-PN-HRRP | 0.9834 | 1.048 | 1.122 | 1.151 | 1.091 | 1.042 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | Alhambra Hospital | US median | CA average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 0.613 | 0.489 | 0.6114 | Worse than 63% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 0.391 | 0.346 | 0.449 | Worse than 57% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | 0.475 | 0.559 | 0.679 | Better than 58% of US hospitals | |
| HAC Reduction Program payment reductionFY 2026 | No | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | 2.358 | 0.6405 | 0.7204 | Worse than 98% of US hospitals | |
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.956 | 0.9628 | 0.9656 | Better than 53% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | 0 | 0.7945 | 0.8116 | The best result, shared by 12% of US hospitals | |
| Total HAC scoreFY 2026 | 0.0747 | -0.0453 | 0.02733 | Worse than 58% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | No | No | N/A | No | No | No |
| Total HAC score | -0.8931 | -0.8926 | 0 | -0.6744 | 0.0422 | 0.0747 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
The Joint Commission (since 2017)
Accreditation
None
Medical school affiliation
Private (for profit)
Ownership type
118
Medicare-certified beds
101
Registered nurses (full-time equivalent)
1966
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Alhambra Hospital reported to Medicare in its latest cost report, covering Jul 1, 2024 to Jun 30, 2025.
4,262
Inpatient discharges
Medicare 26%, Medicaid 2%
19,561
Inpatient days
53% of available bed days used
474
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 825346). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Alhambra Hospital reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 5,631 | 313 | 13,617 | 19,561 |
| Discharges | 1,108 | 89 | 3,065 | 4,262 |
| Average length of stay | 5.1 days | 3.5 days | 4.4 days | 4.6 days |
| Average daily census | 15.4 | 0.9 | 37.3 | 53.6 |
6,347
Medicare Advantage days
1,257 discharges
5,871
Medicaid managed care days
1,399 discharges
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 88 | 17,349 | 5,091 | 54% |
| Intensive care unit | 13 | 2,212 | 540 | 47% |
| Subprovider - irf | 17 | 2,869 | 2,262 | 46% |
| Skilled nursing facility | 26 | 9,099 | 150 | 96% |
Source: CMS cost report (HCRIS, Form 2552-10), report 825346, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What Alhambra Hospital treats Medicare patients for most often, in 2024. 575 Medicare discharges in 21 published DRGs; 0% surgical; 86% in DRGs with complications (CC or MCC).
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 141 | $119,435 | $19,154 | $34,875 | 1.98 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 49 | $102,878 | $16,128 | $30,041 | 1.70 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 49 | $75,782 | $12,419 | $22,128 | 1.33 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 45 | $84,450 | $12,484 | $24,659 | 1.32 |
| Heart failure and shock with MCCMS-DRG 291, medical | 29 | $79,453 | $11,770 | $23,200 | 1.28 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 29 | $92,552 | $16,997 | $27,025 | 1.79 |
| Renal failure with MCCMS-DRG 682, medical | 26 | $69,510 | $13,624 | $20,297 | 1.50 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 24 | $71,526 | $9,539 | $20,886 | 1.03 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 20 | $62,486 | $11,011 | $18,246 | 1.17 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 18 | $105,299 | $16,084 | $30,747 | 1.62 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 16 | $49,113 | $7,364 | $14,341 | 0.81 |
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 15 | $82,489 | $17,911 | $24,087 | 2.00 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 14 | $89,696 | $10,793 | $26,191 | 1.10 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 14 | $60,457 | $6,929 | $17,654 | 0.79 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 13 | $59,516 | $13,062 | $17,379 | 1.59 |
| Chest painMS-DRG 313, medical | 13 | $49,351 | $6,525 | $14,411 | 0.72 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 13 | $64,004 | $8,028 | $18,689 | 0.94 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 12 | $66,778 | $7,258 | $19,499 | 0.82 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 12 | $57,398 | $8,979 | $16,760 | 0.98 |
| Renal failure with CCMS-DRG 683, medical | 12 | $65,564 | $8,298 | $19,145 | 0.90 |
See all 21 Medicare inpatient DRGs at Alhambra Hospital
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
The comprehensive outpatient service groups (APCs) Alhambra Hospital billed Medicare for most in 2024: 149 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 1 Intraocular ProceduresAPC 5491 | 73 | 65 | $21,039 | $2,188 | $1,752 |
| Comprehensive Observation ServicesAPC 8011 | 40 | 39 | $25,557 | $2,679 | $2,090 |
| Level 2 Upper GI ProceduresAPC 5302 | 25 | 22 | $15,799 | $1,858 | $1,445 |
| Level 4 Gynecologic ProceduresAPC 5414 | 11 | 11 | $18,553 | $3,062 | $2,389 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.
ZIP codes with the most Medicare inpatient stays at Alhambra Hospital in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 1,753 in 2020 to 2,084 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 91801 | 328 | 16% | 1,460 | $24.9M | 17% | 21% |
| 90032 | 300 | 14% | 1,511 | $26.8M | 20% | 20% |
| 91803 | 192 | 9% | 840 | $14.6M | 21% | 25% |
| 91770 | 126 | 6% | 569 | $9.2M | 6% | 5% |
| 91754 | 86 | 4% | 408 | $6.9M | 7% | 9% |
| 90031 | 81 | 4% | 370 | $6.1M | 8% | 13% |
| 91776 | 75 | 4% | 473 | $7.7M | 7% | 7% |
| 91732 | 67 | 3% | 320 | $5.4M | 4% | 2% |
| 91755 | 61 | 3% | 377 | $6.1M | 7% | 9% |
| 90012 | 56 | 3% | 305 | $4.8M | 5% | 4% |
| 91780 | 47 | 2% | 288 | $4.6M | 4% | 3% |
| 91706 | 46 | 2% | 291 | $4.4M | 2% | 1% |
| 90042 | 43 | 2% | 182 | $3.2M | 3% | 5% |
| 91745 | 35 | 2% | 173 | $2.7M | 2% | 1% |
| 91789 | 35 | 2% | 130 | $2.3M | 3% | |
| 90640 | 34 | 2% | 188 | $3.1M | 1% | 1% |
| 91731 | 33 | 2% | 208 | $3.2M | 4% | 4% |
| 91007 | 32 | 2% | 170 | $3.3M | 3% | 2% |
| 91733 | 32 | 2% | 182 | $3.1M | 3% | 3% |
| 91775 | 32 | 2% | 176 | $2.9M | 4% | 2% |
| 91748 | 29 | 1% | 170 | $2.7M | 2% | 2% |
| 91030 | 21 | 1% | 97 | $1.6M | 3% | 6% |
| 91744 | 21 | 1% | 98 | $1.7M | 1% | 1% |
| 90022 | 19 | 1% | 62 | $1.2M | 1% | |
| 91790 | 19 | 1% | 96 | $1.6M | 1% |
Source: CMS Hospital Service Area file. Shares are of the 2,084 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units Alhambra Hospital reported at its latest Medicare certification survey (2017). Counts are people, not full-time equivalents.
17
Rehabilitation unit beds
101
Registered nurses
32
Licensed practical nurses
25
Respiratory therapists
1
Social workers
223
Other personnel
Source: CMS Provider of Services file.
150 clinicians who bill Medicare list Alhambra Hospital as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
Weber Chen, M.D.
Hematology & Oncology Physician
NPI 1679504393
See commercial rates for Weber Chen, M.D.Yuhuan Lan, M.D.
Physical Medicine & Rehabilitation Physician
NPI 1164476511
See commercial rates for Yuhuan Lan, M.D.Ramin Akhavan, M.D.
Diagnostic Radiology Physician
NPI 1861561300
See commercial rates for Ramin Akhavan, M.D.Patrick Browning, M.D.
Diagnostic Radiology Physician
NPI 1780691287
See commercial rates for Patrick Browning, M.D.Kok Chye Tan, MD
Neuroradiology Physician
NPI 1891974283
See commercial rates for Kok Chye Tan, MDYih Kok, M.D.
Cardiovascular Disease Physician
NPI 1518928829
See commercial rates for Yih Kok, M.D.Tai Wu, MD
Internal Medicine Physician
NPI 1417963661
See commercial rates for Tai Wu, MDFelix Chi-Ming Yip, M.D.
Urology Physician
NPI 1912088162
See commercial rates for Felix Chi-Ming Yip, M.D.Saro Kasparian, M.D.
Hematology & Oncology Physician
NPI 1104350917
See commercial rates for Saro Kasparian, M.D.Ming-Wei Wu, D.O.
Surgery Physician
NPI 1578500336
See commercial rates for Ming-Wei Wu, D.O.Eddie Hu, M.D.
Specialist
NPI 1871537738
See commercial rates for Eddie Hu, M.D.Dustin Lee, D.O.
Surgery Physician
NPI 1396907432
See commercial rates for Dustin Lee, D.O.Henry Yee, MD
Cardiovascular Disease Physician
NPI 1285724724
See commercial rates for Henry Yee, MDMohan Rao, MD
Internal Medicine Physician
NPI 1265467435
See commercial rates for Mohan Rao, MDHenry Tseng, DPM
Podiatrist
NPI 1295733855
See commercial rates for Henry Tseng, DPMJohn Liu, MD
Physical Medicine & Rehabilitation Physician
NPI 1194739797
See commercial rates for John Liu, MDShane Pak, MD
Orthopaedic Surgery Physician
NPI 1528002334
See commercial rates for Shane Pak, MDChia Chi Lai, M.D.
Gastroenterology Physician
NPI 1043238413
See commercial rates for Chia Chi Lai, M.D.Bosheng Qiu, M.D
Internal Medicine Physician
NPI 1417096363
See commercial rates for Bosheng Qiu, M.DJun Xu, M.D.
Internal Medicine Physician
NPI 1497010391
See commercial rates for Jun Xu, M.D.Jason Boutros, M.D.
Specialist
NPI 1942243563
See commercial rates for Jason Boutros, M.D.Michael Brand, M.D.
Diagnostic Radiology Physician
NPI 1659317667
See commercial rates for Michael Brand, M.D.Anil Gupta, MD
Internal Medicine Physician
NPI 1538182407
See commercial rates for Anil Gupta, MDZhenghong Yuan, MD
Family Medicine Physician
NPI 1689865065
See commercial rates for Zhenghong Yuan, MDSource: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income Alhambra Hospital reported to Medicare for Jul 1, 2024 to Jun 30, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $548.6M | 597.4% |
| Inpatient | $419.8M | 457.1% |
| Outpatient | $128.8M | 140.3% |
| Contractual allowances and discounts | -$456.7M | -497.4% |
| Net patient revenue | $91.8M | 100.0% |
| Operating expenses | -$268.8M | -292.7% |
| Operating income from patient care | -$177M | -192.7% |
| Other income | $200M | 217.8% |
| Net income | $23M | 25.0% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $77.1M | 14.1% |
| Medicaid (including managed care) | $217.5M | 39.6% |
| Other payers and self-pay | $254M | 46.3% |
| Total charges | $548.6M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 825346, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from Alhambra Hospital's latest cost report.
-192.7%
Operating margin
Operating income from patient care / net patient revenue
7.9%
Total margin
Net income / net patient revenue plus other income
9.0%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
25% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$47.52
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
11.0%
Return on assets
Net income for a year / total assets
33.2%
Return on equity
Net income for a year / fund balance
1.47
Current ratio
Current assets / current liabilities
1.36
Quick ratio
Cash, temporary investments and net receivables / current liabilities
231 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
78 days
Days in patient receivables
Net patient receivables / daily net patient revenue
189 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.40
Asset turnover
Total revenue for a year / total assets
115.3 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 825346, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Alhambra Hospital owned and owed at the end of its reporting period (Jun 2025), across all fund types: $208.5M in total assets and a $69.3M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $170.2M | 81.7% |
| Patient receivables, net | $19.6M | 9.4% |
| Inventory | $1M | 0.5% |
| Total current assets | $205.3M | 98.5% |
| Property and equipment, net of depreciation | $3.2M | 1.5% |
| Total assets | $208.5M | 100.0% |
| Current liabilities | $139.2M | 66.8% |
| Total liabilities | $139.2M | 66.8% |
| Fund balance (net assets) | $69.3M | 33.2% |
Source: CMS cost report (HCRIS, Form 2552-10), report 825346, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Alhambra Hospital provided without full payment, as reported on Worksheet S-10 of its cost report.
$550,570
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$485,977
Bad debt
Patient bills written off as uncollectible, at charges
$36.4M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$37.1M
Total unreimbursed and uncompensated care
13.8% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 825346, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Alhambra Hospital's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Jun 2020 | Jun 2021 | Jun 2022 | Jun 2023 | Jun 2024 | Jun 2025 |
|---|---|---|---|---|---|---|
| Net patient revenue | $73.1M | $81.1M | $237.3M | $86M | $73.1M | $91.8M |
| Operating expenses | $199.9M | $226.4M | $227.6M | $259.9M | $278.7M | $268.8M |
| Operating margin | -173.3% | -179.1% | 4.1% | -202.2% | -281.5% | -192.7% |
| Net income | $7.3M | $10.8M | $11.3M | $10.1M | -$5M | $23M |
| Total assets | $131.9M | $192.4M | $179.1M | $170.6M | $179.9M | $208.5M |
| Discharges | 4,107 | 3,658 | 3,588 | 4,032 | 3,960 | 4,262 |
| Inpatient days | 18,596 | 18,868 | 17,831 | 21,828 | 20,425 | 19,561 |
| Medicare Advantage days | 3,889 | 5,448 | 5,046 | 6,162 | 5,823 | 6,347 |
| Beds | 144 | 144 | 144 | 144 | 144 | 144 |
| Employees (FTE) | 561 | 454 | 456 | 528 | 507 | 474 |
Source: CMS cost report (HCRIS, Form 2552-10), report 825346, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Alhambra Hospital reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Operating room | $3.5M | $15.4M | $53.2M | 0.29 | 15,541 |
| Medical supplies charged to patient | $12.4M | $13.1M | 0.94 | ||
| Emergency | $3.5M | $12M | $45.4M | 0.27 | 6,268 |
| Drugs charged to patients | $11.6M | $42.3M | 0.27 | ||
| Radiology-diagnostic | $1.8M | $7.7M | $18.6M | 0.41 | 13,616 |
| Laboratory | $2.3M | $7.1M | $80.5M | 0.09 | 3,570 |
| Respiratory therapy | $2.6M | $6.5M | $41.1M | 0.16 | 1,014 |
| Impl. dev. charged to patients | $2.7M | $8.4M | 0.32 | ||
| Physical therapy | $489,101 | $2.4M | $9.2M | 0.26 | 4,858 |
| Electrocardiology | $123,648 | $1.4M | $11.3M | 0.12 | 3,158 |
| Renal dialysis | $1M | $5.5M | 0.19 | 230 | |
| Ct scan | $1M | $55.6M | 0.02 | 762 | |
| Radioisotope | $219,163 | $522,330 | $1.3M | 0.39 | 420 |
| Speech pathology | $188,945 | $875,900 | 0.22 | 480 | |
| Mri | $112,847 | $4.1M | 0.03 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $12.9M | $39.8M | $97M | 0.41 | 19,374 |
| Skilled nursing facility | $3.8M | $12.2M | $29.6M | 0.41 | 12,068 |
| Intensive care unit | $3.6M | $10.7M | $19.3M | 0.56 | 5,268 |
| Subprovider - irf | $3.4M | $10.4M | $12.1M | 0.86 | 8,804 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $7.7M | $65.3M | 177,906 | $43.15 | 17,062 |
| Operation of plant | $6.7M | 16,432 | |||
| Medical records & library | $663,708 | $3.8M | 18,479 | $35.92 | 2,725 |
| Pharmacy | $2.6M | $3.2M | 42,847 | $59.73 | 1,304 |
| Cap rel costs-bldg & fixt | $2.7M | 156,074 | |||
| Nursing administration | $2.1M | $2.7M | 39,701 | $51.81 | 1,475 |
| Central services & supply | $208,065 | $2.2M | 7,589 | $27.42 | 11,798 |
| Housekeeping | $1.9M | 1,141 | |||
| Cafeteria | $679,345 | $1.6M | 27,022 | $37.12 | 2,045 |
| Cap rel costs-mvble equip | $1M | ||||
| Dietary | $781,982 | $904,653 | 25,642 | $17.87 | 5,233 |
| Employee benefits department | $423,767 | $570,670 | 8,622 | $49.15 | 377 |
| Laundry & linen service | $372,763 | 1,051 | |||
| Maintenance & repairs | $761 |
Source: CMS cost report (HCRIS, Form 2552-10), report 825346, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
The factors Medicare uses to set what it pays Alhambra Hospital for an inpatient stay.
1.65
Case mix index
Higher than 46% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
67.0%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
1,174
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Urban (metro area)
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).
| IPPS fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 | FY 2027 |
|---|---|---|---|---|---|---|---|
| Case mix index | 1.49 | 1.49 | 1.82 | 1.78 | 1.67 | 1.68 | 1.65 |
| Wage index | 1.290 | 1.284 | 1.297 | 1.519 | 1.451 | 1.431 | 1.399 |
| Readmissions adjustment | -0.09% | -0.07% | -0.38% | 0.00% | -1.07% | -0.64% | -0.29% |
| Value-based purchasing adjustment | +0.97% | +1.57% | +1.57% | -0.14% | -0.24% | -0.78% | +0.52% |
| Medicare inpatient stays | 1,226 | 1,226 | 862 | 884 | 985 | 935 | 1,174 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations Alhambra Hospital reports to Medicare as owners or with operational control. 4 individuals also hold ownership interests; they are not listed here.
Alhambra Hospital Medical Center, LP
5% or greater direct ownership interest, 100%, since 1998
Ahmc, Inc.
5% or greater indirect ownership interest, 10%, since 1998
Ahmc, Inc.
General partnership interest, since 1998
Sources: CMS Hospital All Owners.
The officers and board members on Alhambra Hospital's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment; the first 3 of 5 are shown.
Alhambra hospital - rehab
CCN 05T281, certified 1966, Medicare prospective payment
Alhambra hospital - snf
CCN 555850, certified 2008, Medicare prospective payment
Source: Worksheet S-2 Part I of Alhambra Hospital's latest Medicare cost report (HCRIS).
About Alhambra Hospital's rates and hospital price transparency.
For MRI of the brain, without contrast (CPT 70551), published negotiated rates at Alhambra Hospital range from $359 to $4,145 across 4 insurers. Aetna's rate is $359. The median at nearby comparable hospitals is $1,025. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Alhambra Hospital range from $323 to $2,994 across 4 insurers. Aetna's rate is $323. The median at nearby comparable hospitals is $1,374. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Alhambra Hospital range from $929 to $4,615 across 3 insurers. Anthem Blue Cross / Blue Shield of CA's rate is $2,026. The median at nearby comparable hospitals is $2,032. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Alhambra Hospital range from $117 to $1,112 across 2 insurers. Aetna's rate is $117. The median at nearby comparable hospitals is $467. What a patient pays depends on their plan's deductible, coinsurance and network status.
Alhambra Hospital has a CMS overall hospital star rating of 4 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is higher than 58% of US hospitals.
CMS reports no Medicare-funded interns or residents at Alhambra Hospital for fiscal year 2027.
Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Alhambra Hospital's base inpatient payments by an estimated 0.29% in fiscal year 2027 for more readmissions than expected.
In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (141 discharges), respiratory infections and inflammations with mcc (49 discharges), simple pneumonia and pleurisy with mcc (49 discharges).
Alhambra Hospital's Medicare case mix index is 1.65 for fiscal year 2027, higher than 46% of hospitals paid under the inpatient prospective payment system.
Alhambra Hospital reported 4,262 inpatient discharges and 19,561 inpatient days from Jul 1, 2024 to Jun 30, 2025.
Alhambra Hospital reported 474 full-time-equivalent employees on payroll from Jul 1, 2024 to Jun 30, 2025.
Alhambra Hospital reported $91.8M in net patient revenue on $548.6M of gross charges for Jul 1, 2024 to Jun 30, 2025, an operating margin of -192.7%, and net income of $23M.
Alhambra Hospital reported $37.1M of unreimbursed and uncompensated care for Jul 1, 2024 to Jun 30, 2025, including $550,570 of charity care at cost.
Alhambra Hospital's Medicare enrollment lists Jonathan Y.h. Wu as CEO Of General Partner Of Provider since 2008.
Insurers' price transparency files list Alhambra Hospital under employer identification number 95-4693289 (Alhambra Hospital Medical Center L.P.). 19 health plans and networks list 95-4693289 for it.
150 clinicians who bill Medicare list Alhambra Hospital as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are internal medicine physician (22), emergency medicine physician (17), family medicine physician (17).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for Alhambra Hospital, effective 2017.
In its Medicare enrollment, Alhambra Hospital reports Alhambra Hospital Medical Center, LP as 5% or greater direct ownership interest (100%).
CMS lists 20 services at Alhambra Hospital, including Acute Renal Dialysis, Anesthesia, Clinical Laboratory, Coronary Care Unit, Diagnostic Radiology, Dietary Care.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Alhambra Hospital came from ZIP codes 91801 (328), 90032 (300), 91803 (192).
Alhambra Hospital has 144 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. 118 are Medicare-certified beds in CMS's Provider of Services file. Facility type: Short Term Acute Care Hospital.
Alhambra Hospital is located at 100 South Raymond Avenue, Alhambra, CA 91801.
Alhambra Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 050281.
The National Provider Identifier (NPI) on file for Alhambra Hospital is 1770612756.
Alhambra Hospital lists 15 in-network payers, including Aetna, Aspirus Health Plan, Avera Health Plans, BCBS, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
120 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers